Long-term outcomes of the benefit-finding group intervention for Alzheimer family caregivers: A cluster-randomized double-blind controlled trial

Sheung-Tak CHENG, Wai Chi CHAN, Linda C.W. LAM

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Objectives: To examine the effects of the group benefit-finding intervention (BFT) for Alzheimer family caregivers up to 10-month follow-up.
Design: Cluster-randomized double-blind controlled trial.
Setting: Social centers and clinics.
Participants: 129 caregivers. Inclusion criteria were (a) primary caregiver aged 18+ and without cognitive impairment, (b) providing ≥14 care hours per week to a relative with mild-to-moderate Alzheimer's disease, and (c) scoring ≥3 on the Hamilton Depression Rating Scale. Exclusion criterion was care-recipient having parkinsonism or other forms of dementia.
Interventions: BFT (using cognitive reappraisal to find positive meanings) was evaluated against two forms of psychoeducation as controls—standard (STD-PE) and simplified (lectures only; SIM-PE) psychoeducation. All interventions had eight weekly sessions of 2 hours each.
Measurements: Primary outcome was depressive symptom, whereas secondary outcomes were global burden, role overload, and psychological well-being. Measures were collected at baseline, post-intervention, and 4- and 10-month follow-up.
Results: Mixed-effects regression showed that BFT's effect on depressive symptoms conformed to a curvilinear pattern, in which the strong initial effect leveled out after post-intervention and was maintained up to 10-month follow-up; this was true when compared against either control group. The effect on global burden was less impressive but moderate effect sizes were found at the two follow-ups. For psychological well-being, there was an increase in the BFT group at 4-month follow-up and a return to baseline afterwards. No effect on role overload was found.
Conclusions: Benefit-finding reduces depressive symptoms as well as global burden in the long-term, and increases psychological well-being in the medium-term. Copyright © 2019 Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry.
Original languageEnglish
Pages (from-to)984-994
JournalThe American Journal of Geriatric Psychiatry
Issue number9
Early online dateMar 2019
Publication statusPublished - Sep 2019


Parkinsonian Disorders
Sexually Transmitted Diseases
Alzheimer Disease
Control Groups


Cheng, S.-T., Chan, W. C., & Lam, L. C. W. (2019). Long-term outcomes of the benefit-finding group intervention for Alzheimer family caregivers: A cluster-randomized double-blind controlled trial. The American Journal of Geriatric Psychiatry, 27(9), 984-994. doi: 10.1016/j.jagp.2019.03.013


  • Dementia caregiving
  • Depression
  • Positive aspects of caregiving
  • Cluster-randomized controlled trial